scholarly journals Markers of myocardial damage and inflammation in patients with coronary artery disease

2004 ◽  
Vol 23 (3) ◽  
pp. 249-253
Author(s):  
Anna Tzontcheva ◽  
Arman Postadjian
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Acute Coronary Syndromes ◽  
Myocardial Damage ◽  
Cardiac Events ◽  
Predictive Values ◽  
Coronary Syndromes ◽  
Artery Disease

To shed light on the clinical significance of elevated CRP levels we performed a comparative analysis of the predictive values of both CRP and TnT in patients with unstable coronary artery disease for the occurrence of major cardiac events within 6 months. CRP and Troponin T were measured on admission in patients with acute coronary syndromes without ST segment elevation. Patients were treated according to a conservative management and the incidence of major cardiac events within 6 months was assessed. A total of 73 patients were included in the study. There were 27 major cardiac events (37%). An abnormal CRP (>4 mg/L) and an abnormal TnT (> 0.01 mg/L) were present in 36 patients (49.3%). The incidence of a major cardiac event was significantly higher among patients with CRP > 4 mg/L than in other patients (63.9 vs 10.8%), and this was evident both in patients with an elevated TnT (85.7 vs 20%) and in those without an elevated TnT (33.3 vs 4.5%). The sensitivity of a concentration of CRP > 4 mg/L for predicting a future ischaemic event was 85%, with a specifity of 72% and negative predictive value of 89%. For TnT > 0.01 mg/L the sensitivity was 77%, specifity 67% and negative predictive value 84%. The present study shows that both CRP, a non-specific acute phase reactant, and TnT, a cardiac specific marker of myocardial damage, are elevated early in a substantial number of patients with acute coronary syndromes. It shows that CRP and TnT are independent prognostic indicators of adverse ischaemic events.

Predictive value of associations between carotid and coronary artery disease in patients with acute coronary syndromes

2005 ◽  
Vol 95 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Roman Komorovsky ◽  
Alessandro Desideri ◽  
Sebastian Coscarelli ◽  
Lauro Cortigiani ◽  
Diego Tonello ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Predictive Value ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes ◽  
Artery Disease

C-Reactive protein and coronary artery disease: Additional evidence of the implication of an inflammatory process in acute coronary syndromes

1999 ◽  
Vol 137 (2) ◽  
pp. 346-351 ◽  
Author(s):  
Idrissia Abdelmouttaleb ◽  
Nicolas Danchin ◽  
Claudio Ilardo ◽  
Isabelle Aimone-Gastin ◽  
Michael Angioï ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Inflammatory Process ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndromes ◽  
Artery Disease

Abstract 5803: Optimal Threshold for Multi Detector Computer Tomography to Detect Physiologically Significant Stenosis in Patients with Ischemic Heart Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Takashi Yamano ◽  
Atsushi Tanaka ◽  
Takashi Tanimoto ◽  
Shigeho Takarada ◽  
Hiroki Kitabata ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Optimal Threshold ◽  
Fractional Flow ◽  
Significant Stenosis ◽  
Artery Disease

PURPOSE: Sixty-four multi detector computed tomography angiography (64-MDCT) has emerged as a rapidly developing method for the noninvasive detection of coronary artery disease with high negative predictive value and relatively low positive predictive value, especially in patients with intermediate-severity coronary artery disease (ISCAD). There are, however, few studies regarding with optimal threshold for detection of physiologically significant stenosis in 64-MDCT. The purpose of this study was to investigate the optimal threshold for 64-MDCT to detect physiologically significant stenosis using fractional flow reserve of the myocardium (FFRmyo) in patients with ISCAD. METHODS: We enrolled single lesions detected by 64-MDCT of 64 ISCAD patients (age, 68.3 +/− 10.2 years; 78% male). FFRmyo </= 0.75 measured by a 0.014-inch pressure wire was used as the gold standard for presence of physiologically significant stenosis. The area stenosis (%AS) in 64-MDCT were compared with the results of FFRmyo and percent diameter stenosis (%DS) in quantitative coronary angiography (QCA) during elective coronary angiography. Using receiver operating characteristic (ROC) analysis, the optimum threshold for percent area stenosis (%AS) in 64-MDCT was determined in the prediction of FFRmyo </= 0.75. RESULTS: There was an inverse correlation between %AS in 64-MDCT and FFRmyo (65 +/− 20 % and 0.71 +/− 0.16, respectively; r = −0.67; p < 0.01). Furthermore, there was a positive correlation between %AS in 64-MDCT and %DS in QCA (65 +/− 20 % and 63 +/− 19 %, respectively; r = 0.69; p < 0.01). Using a cutoff of 62 %AS in 64-MDCT, ROC curve analysis shows 79 % sensitivity, 85 % specificity, 82% positive predictive value, 83% negative predictive value and 83% accuracy for detecting physiologically significant stenosis. CONCLUSION: > 62 %AS in 64-MDCT could predict the physiologically significant coronary stenosis in patients with ISCAD. Applying an alternative threshold to detect physiologically significant stenosis might contribute to improve the diagnostic accuracy for 64-MDCT in patients with ISCAD.

Abstract 15233: The Lesion Length Gives a Better Effect on the Fractional Flow Reserve Than the Minimal Luminal Area in the Intermediate Coronary Artery Lesion

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoon Juneyoung ◽  
Xiongjie Jin ◽  
Kyong-Woo Seo ◽  
Jin-sun Park ◽  
Hyoung-Mo Yang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Lesion Length ◽  
Visual Estimation ◽  
Luminal Area ◽  
Artery Disease

Introduction: The pressure gradient of the circulation fluid in a stenosis area depends on minimal luminal area (MLA) of the stenosis, lesion length (LL), and the fluid velocity. However, the correlation of the LL and the MLA; the cutoff values are uncertain. Hypothesis: LL and MLA differently influences the FFR. Methods: We studied 117 patients with intermediate coronary artery disease who underwent FFR and IVUS measurement out of 302 patients in FAVOR study. This study was a prospective, 1:1 randomized, open label multicenter trial to demonstrate the clinical outcomes between FFR and IVUS-guided PCI. Inclusion criteria were as follows: 1)Angina or documented silent ischemia 2) De novo intermediate coronary artery disease (30-70% diameter stenosis) by visual estimation, 3) Reference vessel diameter ≥ 3.0mm by visual estimation. We excluded left main disease, MI, EF< 40%, and graft vessel. There were no significant differences in baseline clinical characteristics. The mean values are the QCA (54.3±14.0 %), MLA (3.6±1.4 mm2) and LL (20.6±1.4mm), respectively. We were performed the path analysis using AMOS 18, and estimated the ROC curve in SPSS 18. Results: Standardized estimates were the LL -0.47,QCA -0.28 and MLA -0.21 (R2=0.594, p<0.000) in path analysis. The model is recursive and statistically significant. The FFR was ≤0.80 in 47 lesions (31%). The optimal LL for an FFR of ≤0.80 was 15.8mm (90% sensitivity, 50% specificity, 44% positive predictive value, 87% negative predictive value, area under the curve: 0.75, 95% CI: 0.66 to 0.85; p < 0.001) and MLA 3.9mm (sensitivity 86%, specificity 59%, 35% positive predictive value , 94% negative predictive value, area under the curve: 0.78, 95% CI: 0.67 to 0.85; p < 0.001) Conclusions: The lesion length influenced more the FFR than MLA. The lesion length ≥ 15.8mm and MLA ≤ 3.9mm are risk zones, which need to be confirm the functional status with FFR because of the low positive predictive value

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